Article: Fire, Aim… Ready? Alberta's Big Bang Approach to Healthcare Disintegration

Alberta's abolition in 2008 of its health regions and the creation of Alberta Health Services (AHS) was a bold move, but the reasons for the change remain hazy. The stated goals were to "help make Alberta's … system more effective and efficient" and to "provide equitable access to health services and long-term sustainability." Data show, however, that Alberta's health regions were already performing well on these goals relative to other provinces, and where changes have since occurred, they cannot necessarily be attributed to AHS.

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References

1.

Ross H, Howlett J, Arnold J, Liu P, ONeill B, Brophy J . Treating the right patient at the right time: access to heart failure care. Can J Cardiol. 2006; 22(9):749-54. PMC: 2560514. DOI: 10.1016/s0828-282x(06)70290-2. View

2.

Mitton C, Patten S, Waldner H, Donaldson C . Priority setting in health authorities: a novel approach to a historical activity. Soc Sci Med. 2003; 57(9):1653-63. DOI: 10.1016/s0277-9536(02)00549-x. View

3.

Martin H, Rushforth P . The big bang approach to health reform: an update from the Calgary Regional Health Authority. Hosp Q. 2000; 2(2):43-50. DOI: 10.12927/hcq..16739. View

4.

Farrar S, Yi D, Sutton M, Chalkley M, Sussex J, Scott A . Has payment by results affected the way that English hospitals provide care? Difference-in-differences analysis. BMJ. 2009; 339:b3047. PMC: 2733950. DOI: 10.1136/bmj.b3047. View

5.

Church J, Barker P . Regionalization of health services in Canada: a critical perspective. Int J Health Serv. 1998; 28(3):467-86. DOI: 10.2190/UFPT-7XPW-794C-VJ52. View

6.

Lewis S, Kouri D . Regionalization: making sense of the Canadian experience. Healthc Pap. 2004; 5(1):12-31. DOI: 10.12927/hcpap.2004.16847. View

7.

Duckett S . Hospital payment arrangements to encourage efficiency: the case of Victoria, Australia. Health Policy. 1995; 34(2):113-34. DOI: 10.1016/0168-8510(95)94014-y. View

8.

Ruta D, Mitton C, Bate A, Donaldson C . Programme budgeting and marginal analysis: bridging the divide between doctors and managers. BMJ. 2005; 330(7506):1501-3. PMC: 558464. DOI: 10.1136/bmj.330.7506.1501. View

9.

Gooch K, Smith D, Wasylak T, Faris P, Marshall D, Khong H . The Alberta Hip and Knee Replacement Project: a model for health technology assessment based on comparative effectiveness of clinical pathways. Int J Technol Assess Health Care. 2009; 25(2):113-23. DOI: 10.1017/S0266462309090163. View

10.

Asthana S, Gibson A, Moon G, Brigham P . Allocating resources for health and social care: the significance of rurality. Health Soc Care Community. 2003; 11(6):486-93. DOI: 10.1046/j.1365-2524.2003.00454.x. View

11.

Graham M, Knudtson M, ONeill B, Ross D . Treating the right patient at the right time: Access to cardiac catheterization, percutaneous coronary intervention and cardiac surgery. Can J Cardiol. 2006; 22(8):679-83. PMC: 2560560. DOI: 10.1016/s0828-282x(06)70936-9. View